Provider Demographics
NPI:1316314305
Name:CONTINI FAMILY MEDICINE LLC
Entity type:Organization
Organization Name:CONTINI FAMILY MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:REBEKAH
Authorized Official - Middle Name:E
Authorized Official - Last Name:CONTINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-547-9991
Mailing Address - Street 1:3269 HIGHWAY 90
Mailing Address - Street 2:
Mailing Address - City:BONIFAY
Mailing Address - State:FL
Mailing Address - Zip Code:32425-6001
Mailing Address - Country:US
Mailing Address - Phone:850-547-9991
Mailing Address - Fax:850-547-9992
Practice Address - Street 1:3269 HIGHWAY 90
Practice Address - Street 2:
Practice Address - City:BONIFAY
Practice Address - State:FL
Practice Address - Zip Code:32425-6001
Practice Address - Country:US
Practice Address - Phone:850-547-9991
Practice Address - Fax:850-547-9992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-26
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME118029207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014273300Medicaid
FL1598026429OtherNPI
FL014273300Medicaid